COVID-19 pandemic has had a significant impact on health services for patients suffering from chronic diseases. Patients suffering from kidney failure require heamodialysis and this modality of treatment is mostly off...COVID-19 pandemic has had a significant impact on health services for patients suffering from chronic diseases. Patients suffering from kidney failure require heamodialysis and this modality of treatment is mostly offered in the hospital. Impacts of COVID-19 pandemic on haemodialysis care at a tertiary institution in South East, Nigeria include a reduction in the number of haemodialysis cases during the period of lockdown, an increase in the cost of heamodialysis, scarcity of materials used for the procedure and minor disruption of haemodialylsis care. An improvement in infection control practice at the dialysis unit is observed as a positive effect. It is advocated that the government should assist patients with kidney disease and make the procedure free to ameliorate the health and socio-economic hardships faced by the patients during the pandemic.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events</...<strong>Background:</strong><span style="font-family:Verdana;"> Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">hence</span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> this study evaluated the prevalence of carotid atherosclerotic plaques in pre-dialysis CKD patients at a tertiary institution in south-east, Nigeria. </span><b><span style="font-family:Verdana;">Materials</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">and</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">107 pre-dialysis CKD patients were consecutively recruited for the study. 81 subjects who were screened and had no kidney disease served as control. The control group was sex and age matched with the CKD patients. A pre-tested questionnaire was administered to all participants and physical examination was done. Presence of atheromatous plaques was assessed using doppler ultrasound at 3 sites—distal common carotid artery (CCA), the internal carotid artery (ICA) and the carotid bulb by a single skilled radiologist specialized in doppler ultrasound. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Atheromatous plaques were significantly increased in CKD patients. 14.2% of CKD patients had atheromatous plaques versus 2.5% in the control group (p value < 0.05). Commonest site of occurrence was at the common carotid artery (CCA-7.5% versus ICA-4.7% versus bulb 1.8%). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Atheromatous plaques are prevalent in CKD patients. It is recommended that carotid doppler ultrasound should be done in CKD patients to identify patients for possible intervention.</span></span>展开更多
Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported i...Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.展开更多
文摘COVID-19 pandemic has had a significant impact on health services for patients suffering from chronic diseases. Patients suffering from kidney failure require heamodialysis and this modality of treatment is mostly offered in the hospital. Impacts of COVID-19 pandemic on haemodialysis care at a tertiary institution in South East, Nigeria include a reduction in the number of haemodialysis cases during the period of lockdown, an increase in the cost of heamodialysis, scarcity of materials used for the procedure and minor disruption of haemodialylsis care. An improvement in infection control practice at the dialysis unit is observed as a positive effect. It is advocated that the government should assist patients with kidney disease and make the procedure free to ameliorate the health and socio-economic hardships faced by the patients during the pandemic.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">hence</span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> this study evaluated the prevalence of carotid atherosclerotic plaques in pre-dialysis CKD patients at a tertiary institution in south-east, Nigeria. </span><b><span style="font-family:Verdana;">Materials</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">and</span></b><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">107 pre-dialysis CKD patients were consecutively recruited for the study. 81 subjects who were screened and had no kidney disease served as control. The control group was sex and age matched with the CKD patients. A pre-tested questionnaire was administered to all participants and physical examination was done. Presence of atheromatous plaques was assessed using doppler ultrasound at 3 sites—distal common carotid artery (CCA), the internal carotid artery (ICA) and the carotid bulb by a single skilled radiologist specialized in doppler ultrasound. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Atheromatous plaques were significantly increased in CKD patients. 14.2% of CKD patients had atheromatous plaques versus 2.5% in the control group (p value < 0.05). Commonest site of occurrence was at the common carotid artery (CCA-7.5% versus ICA-4.7% versus bulb 1.8%). </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Atheromatous plaques are prevalent in CKD patients. It is recommended that carotid doppler ultrasound should be done in CKD patients to identify patients for possible intervention.</span></span>
文摘Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.